ABSTRACT
Objective: Sickle cell disease (SCD) is the most common hemoglobinopathy where morphologic changes to red blood cells affect the development of hard and soft tissues. The purpose of this study is to identify the craniofacial characteristics and maxillomandibular relationship in SCD patients and compare with unaffected subjects, through cephalometric radiographic assessment. Materials and Methods: The study included 44 Kuwaiti SCD patients (20 female, 24 male) as well as 44 age and gender matched controls. Digital lateral cephalometric, radiographs were recorded. SNA and ANB angles were measured and compared. Results: The mean SNA angle was found to be higher among the SCD cases (83.00 ± 3.22) than in controls (81.78 ± 4.58), but the difference was not statistically significant, (p = 0.146). The mean ANB angle in SCD cases (5.27 ± 2.36) was significantly higher, than that in controls (3.97 ± 2.23). The difference in means was statistically significant, (p = 0.01). Almost 50% of the SCD patients had class II malocclusion and 61.5% of the patients had prognathic maxilla. Conclusions: Patients with SCD in Kuwait exhibited characteristics of skeletal class II pattern malocclusion. They also showed evidence of compensatory maxillary expansion.
ABSTRACT
BACKGROUND: The study compared clinical decisions regarding root angulation correction and root proximity based on the interpretation of Panoramic (PAN) versus Cone-Beam Computed Tomography (CBCT) images. METHODS: A total of 864 teeth from 36 existing, radiographic patient records at a university dental clinic with concurrent PAN and CBCT images were assessed using PANs, then using CBCTs in a blinded manner by two orthodontists. Teeth were rated regarding the need for root repositioning, the direction of repositioning and existence of root proximity. Frequencies, rating time and intra- and inter-examiner Cohen's Kappa were calculated. RESULTS: There was 73.7-84.5% agreement between PAN-based and CBCT-based orthodontists' decisions regarding the need to reposition roots. Root proximity was more frequently reported on PANs than CBCTs by one examiner (p = 0.001 and p = 0.168). Both PANs and CBCTs had moderate to substantial intra-examiner, within-radiograph-type reliability with Kappa values of 0.686-0.79 for PANs, and 0.661 for CBCTs (p < 0.001). Inter-examiner and inter-radiograph-type Kappa values ranged from 0.414 to 0.51 (p < 0.001). Using CBCT decisions as a reference, 78.9% of PAN decisions were coincident, 9.3% would have been repositioned on CBCT but not on PAN, 11.3% would not have been repositioned on CBCT but were on PAN, and 0.3% would have been repositioned in the opposite direction on CBCT versus PAN. Additionally, CBCT images required more time per tooth to assess than PANs (p < 0.001). CONCLUSIONS: PAN-based clinical decisions regarding root angulation had comparable statistical reliability and substantial agreement with CBCT-based clinical decisions.
